Lauren Terry Blackburn, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Raeford, NC
NPI 1922476274 · NPPES record last updated Mar 8, 2018
Key facts
- NPI
- 1922476274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C011019 (NC)
- Practice address
- 218 S Main St
Raeford, NC 28376-3204 - Phone
- (910) 875-6042
- Fax
- (910) 875-6065
- NPI assigned
- Sep 3, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Verna Dority MSW CCSW Inc
Practice addresses (Care Compare)
340 Commerce Ave
Suite 11
Southern Pines, NC 28387-7115
Phone (910) 725-6336
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180702000469 | NC | Practitioner - Clinical Social Worker | 6709132913 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P009808 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solas Health PLLC | Current |
Accepting new patients | |
| Verna Dority, MSW, CCSW, Inc | Clinical | Current |
Accepting new patients |
| Spectrum Recovery Inc | Past |
Accepting new patients | |
| Carolina Solution, Inc. | Clinical | Past | Accepting new patients |
| Pinehurst OBGYN Associates PA | Past |
Accepting new patients |
Locations
2911 Breezewood Ave
Ste 101
Fayetteville, NC 28303
Phone (910) 677-9488
602 E Academy St
Ste 103
Fuquay Varina, NC 27526
Phone (910) 762-3185
4308 Ludgate St
Lumberton, NC 28358
Phone (910) 671-9298
285 Olmsted Blvd
Ste 1
Pinehurst, NC 28374
Phone (910) 295-7246
8001 Creedmoor Rd
Ste 107
Raleigh, NC 27613
Phone (919) 460-7246
201 Commercial Ct
Sanford, NC 27330
Phone (910) 295-7246
340 Commerce Ave
Ste 11
Southern Pines, NC 28387
Phone (910) 725-6336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P009808 | NC | |
| Clinical Social Worker | 1041C0700X | C011019 | NC | Yes |
Addresses
Primary practice location
218 S Main St
Raeford, NC 28376-3204
Mailing address
1023 Fairfield Cir
Raeford, NC 28376-6607
Phone (910) 550-3803
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922476274 | Medicaid | NC |
Other providers in Raeford, NC
- Rashauna Bethea
- Lilian Bezue
- Bilingual Therapy Services
- Jessica Charlene Billups
- Birth and Womens Care PA
- Evita Adicie Pena Blackwell
- Sherry Michelle Bland
- Blaze Home Care LLC
- Hannah-Leigh Barham Block
- Yolanda Sherell Bolding
All providers in Raeford, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.